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Much of the management effort in the National Health Service (NHS) over the last few years has been directed towards increasing the responsiveness of the service to the consumer. The aims set out in the 1989 White Paper, Working for Patients, are explored, concentrating on the cultural and structural changes within the NHS that, in the area of customer orientation and service, are necessary for success in the new market economy. The involvement of the consumer in all aspects of the delivery of health care is stressed.

Aims to assess the development of clinical governance within NHS Trusts in the West Midlands by means of a cross‐sectional qualitative study based on in‐depth interviews and observation with all acute and non‐acute (n equals 43) Trusts in the West Midlands Region to determine the rating of Trusts’ competencies across five areas of clinical governance. There was a fourfold variation in the development of clinical governance across Trusts, measured against the identified competencies. Trusts with high competency scores showed a number of characteristics, including clear leadership at executive team level for the agenda, a collaborative style of working between clinicians and management, clinicians involved in management and a culture of openness and empowerment of front‐line staff. Concludes that attention must be paid to the organisational and cultural environment within Trusts, as well as resource issues, if high quality clinical governance is to become the norm

A discussion is presented of the elements in Human Resource Planning and how they can be incorporated into a common denominator of costs. This is the framework for a report on a study of loss and recruitment of nurses in a typical district general hospital and analysis of the nurse labour market in the light of future developments proposed for the NHS.

In recent years, organisations around the world have been seriously affected by a range of economic, political and social upheavals that have gathered momentum in most parts of the globe. The viability of the conventional (pyramidal) organisational structures is being challenged in conjunction with major shifts in the roles of mid and top managers. In many countries, the pace of the above socio‐economic events and uncertainties is happening at an unprecedented pace. Some markets are showing signs of potential gigantic expansions while others (historically prosperous) are on the verge of complete collapse (Dent, 1991). In responding to the socio‐economic challenges of the nineties, organisations (across the board) have resorted to dismantling the conventional pyramidal structure and adopting so‐called “leaner” structures (see Zeffane, 1992). The most common struggle has been to maintain market share in an economic environment increasingly characterised by excess labour supply (Bamber, 1990; Green & Macdonald, 1991). As organisations shifted their strategies from “mass production” to “post‐fordism” (see, for example Kern and Schumann, 1987), there has been a significant tendency to emphasise flexibility of both capital and labour in order to cater for the niche markets which are claimed to be rapidly emerging, world‐wide. This has resulted in massive organisational restructuring world‐wide.

The purpose this paper is to explore walking with purpose in extra care, retirement and domestic housing settings to better understand and support people living with dementia in these settings, develop recommendations and inform practice.

A mixed-methods study was used: scoping literature review; online survey of extra care and retirement housing managers in the UK; case studies involving interviews with staff and family carers (n = 14) of ten individuals who engaged in walking with purpose in the different housing settings.

Although residents who walk with purpose constitute a minority (0–2 residents), managing walking with purpose can be challenging and time consuming. Distraction or redirection was the most common response. Other strategies included identifying the resident’s motivations and accommodating their wishes or walking with them. Culture of care, staff training and dementia-friendly design are keys to effective support for safe walking with purpose. Responses to walking with purpose in the domestic housing settings have raised serious deprivation of liberty issues.

This study had a number of limitations. The completed survey questionnaires represent a self-selected sample of extra care and retirement housing settings, and responses are based on the perceptions of the staff members completing the survey. There were a relatively small number of case study sites (three extra care housing and three retirement housing), and it was not possible to interview family members for all of the residents who walked with purpose.

This study provides unique data on walking with purpose in extra care and retirement housing setting in the UK.

Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD.

Data was collected from the baseline assessment of individuals (n = 55) taking part in a randomized controlled trial examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people.

Both age groups demonstrated complex and severe clinical profiles, including high-frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups.

Similarity between the two groups suggests that the complex problems seen in emerging adults with PTSD + SUD are likely to have had their onset in adolescence or earlier and to have been present for several years by the time individuals present for treatment.

To the best of the authors’ knowledge, this is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD + SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD + SUD.

The study, within the Increasing Resilience of Cultural Heritage (ResCult) project, aims to support civil protection to prevent, lessen and mitigate disasters impacts on cultural heritage using a unique standardised-3D geographical information system (GIS), including both heritage and risk and hazard information.

A top-down approach, starting from existing standards (an INSPIRE extension integrated with other parts from the standardised and shared structure), was completed with a bottom-up integration according to current requirements for disaster prevention procedures and risk analyses. The results were validated and tested in case studies (differentiated concerning the hazard and type of protected heritage) and refined during user forums.

Besides the ensuing reusable database structure, the filling with case studies data underlined the tough challenges and allowed proposing a sample of workflows and possible guidelines. The interfaces are provided to use the obtained knowledge base.

The increasing number of natural disasters could severely damage the cultural heritage, causing permanent damage to movable and immovable assets and tangible and intangible heritage. The study provides an original tool properly relating the (spatial) information regarding cultural heritage and the risk factors in a unique archive as a standard-based European tool to cope with these frequent losses, preventing risk.

Despite the interest in non-profit and sustainable ways of connecting farms to society, less is known about how to conduct this through digital technology and communication. Thus, the purpose of this paper is to discuss how to connect farms to society through digital technology and communication.

In-depth interviews of 15 Australian farmers were conducted in order to understand their perceptions of how to engage in digital forms of social entrepreneurship and thematic analysis techniques were utilized to understand the content from the interview transcripts.

The findings suggest that digital social farm entrepreneurship can be categorized into social bricoleurs, social constructionists and social engineers.

This typology helps to understand the contextual role farm entrepreneurs play in rural economies and their place in global societies.

Many Australian farms are in remote locations far from urban centers, which makes digital forms of social entrepreneurship an important way that farmers can promote social entrepreneurial ventures.

This paper highlights how there has been a growing interest in developing social entrepreneurship in Australian farms due to their connection with rural communities and environments.

The purpose of this study is to develop and test a theoretical model of Fairtrade buying behavior that supports Sustainable Development Goals (SDGs) by addressing the nexus between just-world beliefs, along with the normative influences, self-identity and altruistic values.

A conceptual framework on the influence of just-world beliefs for Fairtrade purchase intentions is proposed to analyze the role of just-world beliefs on the effects of normative influences and altruistic values for the intention to purchase Fairtrade products that support SDGs. These conceptualizations are empirically tested on a representative sample of 217 consumers.

Just-world beliefs play a central role in the purchase intention by having a direct effect on purchase intention and an indirect effect mediated by personal norms and self-identity. They partially mediate the effects of altruistic values and social norms on the purchase intention of Fairtrade products that support SDGs.

The research provides a better understanding of the influences of these contextual variables on ethical consumption and contributes to both the theory and practice of how businesses can achieve SDGs. The psychological rationale of just-world beliefs provides a new approach to marketing strategy and communication aimed at increasing purchase intention of Fairtrade products that support the fundamental goals of the UN sustainable development.